title: Co-exposure to lead increases the renal response to low levels of cadmium in metallurgy workers.
abstract: OBJECTIVE
  Research on the effect of co-exposure to Cd and Pb on the kidney is scarce. The objective of the present study was to assess the effect of co-exposure to these metals on biomarkers of early renal effect.
  
  
  METHODS
  Cd in blood (Cd-B), Cd in urine (Cd-U), Pb in blood (Pb-B) and urinary renal biomarkers, i.e., microalbumin (μ-Alb), beta-2-microglobulin (β₂-MG), retinol binding protein (RBP), N-acetyl-β-d-glucosaminidase (NAG), intestinal alkaline phosphatase (IAP) were measured in 122 metallurgic refinery workers examined in a cross-sectional survey.
  
  
  CONCLUSIONS
  The median Cd-B, Cd-U, Pb-B were: 0.8 μg/l (IQR = 0.5, 1.2), 0.5 μg/g creatinine (IQR = 0.3, 0.8) and 158.5 μg/l (IQR = 111.0, 219.3), respectively. The impact of Cd-B on the urinary excretion of NAG and IAP was only evident among workers with Pb-B concentrations ≥ 75th percentile. The association between Cd-U and the renal markers NAG and RBP was also evidenced when Pb-B ≥ 75th percentile. No statistically significant interaction terms were observed for the associations between Cd-B or Cd-U and the other renal markers under study (i.e., μ-Alb and β2-MG). Our findings indicate that Pb increases the impact of Cd exposure on early renal biomarkers.
authors.affiliation: Department of Epidemiology and Social Medicine, University of Antwerp, Antwerp, Belgium. Electronic address: ramona.hambach@ua.ac.be.
authors.forename: R
authors.initials: R
authors.lastname: Hambach
authors.forename: D
authors.initials: D
authors.lastname: Lison
authors.forename: P C
authors.initials: PC
authors.lastname: D'Haese
authors.forename: J
authors.initials: J
authors.lastname: Weyler
authors.forename: E
authors.initials: E
authors.lastname: De Graef
authors.forename: A
authors.initials: A
authors.lastname: De Schryver
authors.forename: L V
authors.initials: LV
authors.lastname: Lamberts
authors.forename: M
authors.initials: M
authors.lastname: van Sprundel
mesh_terms: D000118:Acetylglucosaminidase / Q000652:urine; D000328:Adult; D001530:Belgium; D015415:Biomarkers / Q000097:blood / Q000652:urine; D002104:Cadmium / Q000008:administration & dosage / Q000097:blood / Q000633:toxicity* / Q000652:urine; D002105:Cadmium Poisoning / Q000097:blood / Q000209:etiology* / Q000503:physiopathology / Q000652:urine; D003430:Cross-Sectional Studies; D004198:Disease Susceptibility; D042241:Early Diagnosis; D006801:Humans; D007854:Lead / Q000008:administration & dosage / Q000097:blood / Q000633:toxicity* / Q000652:urine; D007855:Lead Poisoning / Q000097:blood / Q000503:physiopathology* / Q000652:urine; D008297:Male; D008669:Metallurgy; D008875:Middle Aged; D009784:Occupational Diseases / Q000097:blood / Q000503:physiopathology* / Q000652:urine; D016273:Occupational Exposure / Q000009:adverse effects*; D051437:Renal Insufficiency / Q000175:diagnosis / Q000209:etiology*; D012177:Retinol-Binding Proteins / Q000652:urine; D012720:Severity of Illness Index; D000078329:Workforce
chemical_list: D015415:Biomarkers; D012177:Retinol-Binding Proteins; D002104:Cadmium; D007854:Lead; D000118:Acetylglucosaminidase
keywords: Biomarkers; Cadmium; Lead; Occupational; Renal